4 Simmering Crises Congress Must Face in 2012

Our intrepid members of Congress return from their year-end holiday and district work sessions breaks in a couple of weeks. While a heaping plate of healthcare concerns will demand their attention, here I focus on four items I'd put at the top of the pile.

1.Fix the SGR
In the current political climate it is laughable to imagine that Congress will look long-term (meaning beyond the next election cycle) and either repeal or replace the sustainable growth rate, but that is exactly what needs to happen.

When the SGR was developed back in 1997, its formula was designed to control Medicare spending on physician services. Everything worked pretty well when the formula was followed, but about 10 years ago Congress began tinkering with the SGR and overriding the formula.

Now doctors are looking at a cumulative 27.4% reduction in reimbursement rates in 2012. Just before its holiday break, Congress did step in and delay the reduction for 60 days with an eye to extending it for a full year, but just about everyone agrees that it's time to bite the bullet and do something permanent with the SGR.

What's particularly egregious is the across-the-board application of the reduction. Cost-conscious physicians get slapped with the same reduction as spendthrifts, which mean there's no incentive to practice the triple aim of better care, better health, and lower costs.

Robert Rucker (1/4/2012 at 1:30 PM)
1 Simmering Crisis that HealthLeaders Media Must Face in 2012: Become more profitable by firing yourselves and letting Obama, Pelosi, and Reid publish the "Health Plan Insider".